The Next Terri Schiavo Case

The announcement in the journal Science that a comatose woman’s brain showed consistent activity while being scanned following verbal cues, sets the stage for the next Terri Schiavo case. When being told to imagine she was playing tennis, for example, the same parts of her brain were activatived that would be activated in a healthy person thinking about playing tennis.

Conservatives will likely jump on this case to undermine the rights of patients to decide in advance what medical interventions they don’t want if they are unable to speak for themselves. But that would be putting politics above science, as the facts show:

– Scientists warn that their findings should not be generalized. For several years, neuroscientists have been working on the idea that there are “minimally conscious states” in which there may be awareness though the person appears not to have any contact with the environment. Many of these same scientists have also cautioned that their findings, including the results just published, should not be generalized to many other cases and especially not to a case like that of Ms. Schiavo.

— The case described in Science does not resemble cases such as Schiavo. While the woman in the recent study had only been unconscious for a few months, the patients in all the classic legal cases — Karen Ann Quinlan, Nancy Cruzan and Terri Schiavo — were in vegetative states for years. Scans of Terri Schiavo’s brain showed that much of it had disappeared, lacking the physical basis of any awareness at all.

Many more studies need to be done to correlate these apparent reactions with factors like length of time of the unconscious state and the physicial condition of the patient’s brain. Policymakers and the public need to rely on the neuroscientists themselves — not right-wing advocates — for guidance on these cases.